Cone Beam Computed Tomography (CBCT) has recently been de- scribed and adopted for extremities imaging

in orthopaedics [1,2,7,8].
During 2015, a new model of CBCT, New Tom 5 G XL (Verona), was used in the Radiology Department of The University of Verona, in

collaboration with the Orthopaedics Department.

This was a development of the well-known cone-beam technology,

more similar to a multi detector computed tomography (MDCT). Indeed, while maintaining unchanged the technical characteristics, the
pulsed emission of a cone beam x-ray and a flat panel detector system, it has a horizontal development with a 58 cm gantry and a table

on which to place the patient.

Compared to previous models, it was possible to extend the field of

application to the osteoarticular apparatus as well, mainly to ortho- paedic field, in particular for the pre-operative planning of fractures as
well as for post-surgical treatment evaluation, even in the presence of metal internal fixation systems (Fig. 1).

The purpose of the study is evaluating the efficacy of this new CBCT,

especially for the diagnosis of extremities small bone fractures, not easily diagnosed at the conventional X-Rays (Fig. 2).

CBCT is an imaging technique consisting of X-ray computed tomo- graphy, in which the x-rays are divergent, forming a cone.

As for MDCT, cone-beam CT is able to produce images in three di- mensions, but the way to achieve this, however, is different. What re-
mains practically unchanged is: the X-ray source, the presence of the gantry (in our case), the system of 360° rotation around the patient and
a detection system opposed to the source on which the collimated beam is projected.

As a result of the acquisition of two-dimensional projection throughout the rotation, CBCT system generates a complete volumetric dataset
with the patient stationary via a single rotation of the x-ray source and detector.

In contrast to CBCT, in MDCT, the patient moves forward through the scanner with the x-ray source and the detector continuously ro- tating
around the gantry.

One of the problems we may encounter when we acquire metal objects, such as synthetic plates or intramedullar nails, is the presence